PDF(Pubmed)
Abstract：
Introduction: This paper describes the peculiarities of the plasma-derived medicinal product (PDMP) market and illustrates the results of a review of the literature on policies aimed at counteracting the shortage of PDMPs. Characteristics of PDMPs: Plasma is primarily used for the industrial production of blood products (80%). The demand for PDMPs, particularly immunoglobulins (IGs), is increasing. However, the production of PDMPs is complex, long (7-12 months), and expensive, accounting, according to US estimates, for 57% of the total costs of PDMPs compared to 14% for small molecules. PDMP market: Unexpected increases in clinical need cannot be addressed in the short term. Once the demand for some diseases is satisfied, the collection and fractionation of plasma will only be used to supply some specific patients. Hence, the full weight of the marginal costs, which remain constant, are borne by a few products. According to last liter economics, the industry stops producing when the marginal revenue equals the marginal cost, thereby reducing the convenience of producing the most commonly used PDMPs (albumin and IG). The imbalance between the demand and supply of PDMPs was exacerbated by the COVID-19 pandemic, which further increased the cost of plasma collection. Shortage issue and possible solutions: Policies to counteract this imbalance have also been discussed. If the demand is inappropriate, it should be reduced. If the demand is appropriate and supply cannot be increased, the demand should be prioritized for patients for whom PDMPs are the only available treatment. If the shortage depends on insufficient supply and technical and allocative efficiency, both production and supply should be improved, together with incentives for all stakeholders involved in the PDMP market to increase the sustainability of production/supply. The paper is focused on this second issue, that is supply-driven unbalance.
摘要：
简介：本文描述了血浆衍生医药产品（PDMP）市场的特殊性，并说明了有关旨在抵消PDMP短缺的政策的文献综述的结果。PDMPs的特点:血浆主要用于血液制品的工业生产(80%)。对PDMP的需求，特别是免疫球蛋白（IGs），正在增加。然而,PDMP的生产是复杂的，长（7-12个月），而且昂贵，会计，根据美国的估计,占PDMPs总成本的57％，而小分子为14％。PDMP市场：短期内无法解决临床需求的意外增加。一旦对某些疾病的需求得到满足，血浆的收集和分割仅用于供应某些特定患者。因此，边际成本的全部权重，保持不变，由少数产品承担。根据最后一升经济学，当边际收益等于边际成本时，行业停止生产，从而降低了生产最常用的PDMPs(白蛋白和IG)的便利性。COVID-19大流行加剧了PDMPs需求和供应之间的不平衡，这进一步增加了血浆收集的成本。短缺问题和可能的解决方案：还讨论了抵消这种不平衡的政策。如果需求不合适，它应该减少。如果需求是适当的，供应不能增加，PDMPs是唯一可用治疗的患者应优先考虑这一需求.如果短缺取决于供应不足以及技术和配置效率，生产和供应都应该改善，以及对参与PDMP市场的所有利益相关者的激励措施，以提高生产/供应的可持续性。本文的重点是第二个问题，这是供应驱动的失衡。
